Past Performance Questionnaire.docx

CONTRACTOR (Offeror) INSERT YOUR NAME HERE USFS Region 4 Road and Bridge Construction MATOC Solicitation 1240LU24R0012 Past Performance Questionnaire

Instructions to Offeror for sending Questionnaires:

This Past Performance Questionnaire should be submitted to the clients of any of the projects listed in Factor 1, Subfactor 1- Experience of the proposal for which there are no Contractor Performance Assessment Reporting System (CPARS) evaluations. For government contracts, send to the Contracting Officer or Contracting Officer’s Representative. For commercial clients, send to personnel with duties similar to those for government contracts. Offerors should follow-up and encourage references to return completed questionnaires in a timely manner.

The offeror shall complete items 1- 10 and send to the clients for completion and submission to the Contracting Officer at: Paul.larsen@usda.gov

USFS Region 4 Road and Bridge Construction MATOC Solicitation 1240LU24R0012 Past Performance Questionnaire We have listed your firm as a reference for the work we have performed for you as listed below. Our firm will be submitting a proposal under a project advertised by the United States Forest Service, Region 4. In accordance with Federal Acquisition Regulations (FAR), the government will evaluate our firm's past performance. Your candid response to the questions below will assist the government evaluation team in this process. Please complete the questions below as thoroughly as possible. Space is provided at the end for additional comments. Only one response is required.

Please return your completed questionnaire directly to the Contracting Officer for the Forest Service at: paul.larsen@usda.gov This documentation must arrive NOT LATER THAN [Contractor to enter date and should note that these questionnaires need to be delivered prior to the solicitation closing date] so that it can be evaluated with our proposal.

If you have questions regarding the attached questionnaire, or require assistance, please contact the Contracting Officer at paul.larsen@usda.gov (primary means) or by telephone at (406) 223-4463. Thank you for your assistance.

ITEMS 1-10 TO BE COMPLETED BY THE OFFEROR:

1. Contractor Name (Offeror):

2. Client or Customer Name and POC:

3. Project Name:

4. Contract Number (if applicable):

5. Contract Value:

6. Description of work performed:

7. Was work performed as a prime or subcontractor?

8. Approximate duration of the project (weeks or days):

9. Project location:

10. Date project completed (if not yet complete list percent completed):

THE FOLLOWING TO BE SENT TO AND COMPLETED BY THE CLIENT:

Please note that while the responses to this questionnaire may be released to the offeror, FAR 15.306(e)(4) prohibits the release of the names of the persons providing the responses. Complete confidentiality will be maintained.

Ratings:

· Outstanding (O): Performance meets contractual requirements and exceeds many to the Government/Owner’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor was highly effective.

· Very Good (VG): Performance meets contractual requirements and exceeds some to the Government’s/Client’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with few problems and corrective actions taken by the contractor were effective.

· Satisfactory (S): Performance meets minimum contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

· Marginal (M): Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions.

· Unsatisfactory (U): Performance does not meet the contractual requirements and correction or recovery is not likely. Contractor corrective actions were ineffective.

· Not Applicable (NA): No information or did not apply to your contract.

PLEASE CIRCLE THE ADJECTIVE THAT BEST REFLECTS YOUR EVALUATION OF THE CONTRACTOR’S PERFORMANCE

QUALITY

SCHEDULE

CLIENT SATISFACTION

MANAGEMENT

COST/FINANCIAL

SAFETY

GENERAL

Please add any additional remarks as needed here (attach up to one additional page if needed):